copyright © 2015 cengage learning® chapter 9 parenteral medication labels and dosage calculation

Copyright © 2015 Cengage Learning®

Chapter 9

Parenteral Medication Labels and Dosage Calculation

Copyright © 2015 Cengage Learning®Copyright © 2015 Cengage Learning®

Parenteral Routes

• IV (intravenous)– Most common

• IM (intramuscular)

• Subcutaneous– Second most common

• Intradermal

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Packaging

• Parenteral medications are available in ampules, vials, prefilled syringes, bag solutions, and bottled solutions.

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Labels of Parental Solutions

• The labels of oral parental solutions are very similar, but the size of the average parental dosage label is much smaller.

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IM Solutions

• Manufactured so average adult dosage is contained in a volume between 0.5 mL and 3 mL.

• Most dosages prepared using 3 mL syringe.

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Subcutaneous Solutions

• Manufactured so average adult dosage is contained in a volume between 0.5 mL and 1 mL.

• Most dosages prepared using 3 mL or TB syringe.

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IV Medication Preparation

• Administration usually two-step procedure:1. Prepare dosage

2. Dilute in IV fluids

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Solution Labels

• Metric/SI (examples)– morphine sulfate 4 mg/mL

– digoxin 75 mcg/mL

– cefazolin 1 gram/50 mL

• Percent (examples)– 1% lidocaine

– 10% calcium gluconate

– 0.45% sodium chloride(continues)

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Solution Labels (cont’d)

• Ratio (examples)– 5000 : 1 heparin

– 2500 : 1 heparin

– 1000 : 1 epinephrine

• International unit (examples)– heparin: 5000 international units

– Factor VIII: 4550 international units

– Factor IX: 2300 international units(continues)

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Solution Labels (cont’d)

• mEq (examples)– 20 mEq potassium chloride (KCl)

– 50 mEq sodium bicarbonate (NaHCO3)

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Safety Point

• Labels of most parenteral solutions are quite small.– Read with particular care.

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Example 1

• Prescription for atropine 1/150 grains subcutaneously

• Atropine vial labeled 0.4 mg/mL

• How many mL should be administered subcutaneously?

(continues)

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Example 1 (cont’d)

• Convert 1/150 grains to 0.4 mg

• Use basic formula:

0.4 mg0.4 mg

1 mL 1 mL

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Example 2

• Prescription for heparin 5000 units subcutaneously

• Heparin vial labeled 10,000 : 1 mL heparin

• How many mL should be administered subcutaneously?

(continues)

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5, 000 units10,000 units

1 mL 0.5 mL

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Example 3

• Prescription for morphine sulfate 2 mg IV

• Morphine sulfate prefilled syringe contains 4 mg/mL

• How many mL should be administered intravenously?

(continues)

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2 mg4 mg

1 mL 0.5 mL

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Example 4

• Prescription for promethazine sulfate 25 mg IV bolus

• Promethazine sulfate vial labeled 25 mg/mL

(continues)

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• IV drug resource states each 12.5 mg of promethazine sulfate should be diluted with 5 mL normal saline for injection prior to administration via IV bolus.

• How many total fluid and medication bolus mL should be administered intravenously?

(continues)

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• Each 12.5 mg requires 5 mL normal saline dilution

• To dilute 25 mg requires 10 mL of normal saline

• 10 mL normal saline + 1 mL (25 mg) medication = 11 mL total volume

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Example 5

• Prescription for 2550 international units Factor IX concentrate intravenously each day

• Pharmacy supplies Factor IX in concentration of 250 international units/5 mL

(continues)

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• How many mL should be administered per intravenous bolus?

(continues)

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2550 units 5 mL 51 mL250 units

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copyright © 2015 cengage learning® chapter 9 parenteral medication labels and dosage calculation

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